The Berrie Center is uniquely situated to contribute to the design and conduct of T1DM trials as part of TrialNet. The Berrie Center combines multi-disciplinary clinical care for patients with diabetes and clinical and basic research programs in diabetes all in one facility. The close geographic proximity of clinicians, scientists, patients, and clinical research subjects facilitates excellent and seamless collaboration and cross-fertilization and provides a unique and vibrant research environment that fosters translational research. The Berrie Center is the only multi- disciplinary diabetes center in New York City, with a large and growing referral base and a staff and patient population interested in type 1 diabetes research. The Berrie Center has been a very productive and contributing member of the TrialNet group. Although we've been a Major Affiliate rather than a Clinical Center for the past several years, our level of participation in the intervention trials has been at the level of a Clinical Center, randomizing 6-7% of total subjects into the treatment and prevention trials. In addition, we have supervised a productive Affiliate Network of 12 TrialNet affiliate sites. Therapeutic targeting of the SYK protein tyrosine kinase is a promising area of clinical investigation. Pre-clinical studies have established that an orally available small molecule syk inhibitor, R788, can prevent collagen-induced arthritis and prevent/treat NZB/NZW lupus nephritis. Phase II clinical studies in rheumatoid arthritis and ITP have demonstrated encouraging efficacy and manageable toxicities and continued evaluation in these diseases as well as in SLE are on-going. We have demonstrated the ability of R788 to inhibit cross-presentation and T1DM development in NOD mice, providing proof-of principal for this approach in T1DM. As a key component of this TrialNet application, we propose an intervention study to investigate its efficacy in human subjects with new-onset T1DM (onset within 100 days of randomization). PUBLIC HEALTH RELEVANCE: Type 1 Diabetes TrialNet studies are designed to address the treatment, prevention and natural history of type 1 diabetes.